Rad to ER

[iffyrad]

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I've not seen this question answered on here so here goes. Matched into rads at a top 15 school, with the intent of doing IR, but the field seems to be in turmoil currently, of which I don't doubt they will come out on top, but even so, the thought of 4 years w/out patients is starting to depress me, granted I have not tried it yet, but ER was a very very close 2nd for me when deciding what to go into, rads won out because honestly I thought I had a better shot (research, lots of contacts) and I didn't realize I loved EM until the beginning of 4th year (so few letters, no research).

So here is my question has anyone heard of someone in my situation: moving from rads to ER...if i decide to pursue this will I have to re-enter the match and repeat my internship? are there EM spots outside of the match at good/great programs? how much explaining will I have to do when I undoubtedly get asked "what makes you think you'll stick it out in EM?" where do I get my letters? ...

thanks!

 

[Doctor Bob]

So here is my question has anyone heard of someone in my situation: moving from rads to ER...

no

if i decide to pursue this will I have to re-enter the match and repeat my internship?

more than likely

are there EM spots outside of the match at good/great programs?

very rarely

how much explaining will I have to do when I undoubtedly get asked "what makes you think you'll stick it out in EM?"

a lot

where do I get my letters?

preferably ER docs

thanks!

no problem

 

[AmoryBlaine]

Agree with everything Dr. Bob said. The competition for an open spot at a good EM program (esp PGY-2 in a 2-4) would be quiet daunting.

What do you mean "the field is in turmoil?" Every rads resident/attending I've met seems happy and satisfied with their jobs. IR seems to be exploding and seems to be rapidly becoming one of the most practical fields in medicine.

 

[dragonfly99]

I would at least try rads for a year or two, and see how you like it. Most rads docs are pretty happy, and I can't say that for some ER docs...the problem with their specialty is
a) lots of bad actor patients (drug seekers, verbally abusive patients, and people with poor problem solving abilities who land in the ER because they make bad decisions and do hazardous stuff and/or choose not to seek out primary care)
b) high liability risk, so end up having to order lots of cover your ass testing and admitting questionable chest pain admissions, etc. for which you have to argue sometimes w/the admitting docs (who don't want to admit the patient).

I have seen very, very few open ER spots at decent programs outside the match.

I think if you want to do it, it would be better to go ahead and do your intern year (in medicine, or whatever) and probably one rads year at least before you think of giving up your spot. That is just what I would do. If you give up your rads spot you probably aren't going to get another one, b/c it's a hard specialty to get. If you later decide you really do want ER, you could potentially switch (using the Match to get a spot) and/or do a 2nd residency in ER...you'd get some credit for your IM or transitional intern year, very likely.

I don't think you should bail on rads b/c you think IR is doomed...I'm not thinking that is true. There will inevitably be turf battles between IR and other specialties, but I'm sure there will be a place for them in the future.

I think if you are still in 4th year, and if there is a possibility of you wanting to switch to ER in the future, you should see if there is any possible way that you can do another ER month now, before you graduate, or do a research block with an ER doctor. Anything to get more experience and possibly a LOR before you are no longer a student.

 

[jtu123]

So I know of 2 people who have switched from Rads to EM, therefore it can be done, I believe one switched as a PGY2 and another as a PGY1, they both had to reenter the match as it is extremely unlikely to find an open spot.

EM is not too far behinds Rads as far as competitiveness level, but if you can get into Rads chances are you will get into EM. Just be careful of letting your Residency funding clock running out, now days it is very hard to find a program to let you train after previous training, mostly for funding reasons. So I would make a decisions fairly quickly next year and if you really want to do EM you should go for it! Personally I could not imagine doing something I didn't feel 100%. Regardless of what people say, EM is a very rewarding field for the right person.

...good luck

 

[TysonCook]

search out why you don't like rads and see if you can incorporate that into your life, or even better find it outside the hospital....are you going to be work all day every day forever???? no, by the time you graduate, it will just be a job.

My brother is finishing his fellowship in IR and LOVES it, but he hated gen rads...stick it out...you'll be surprised.

Lastly, all fields have "turmoil", including EM, search your motives and if you sincerely can't be happy...start talking to PD's etc 🙂

 

[iffyrad]

it's not that I don't like rads, I think it's by far the most interesting/intellectual field in medicine, the appeal was/is, they get to see everything and it's very versatile (like ER), but it seems that other people are realizing that too i.e. ortho/cards/vasc surgery and have eaten up or are trying to take up the other good stuff, and I knew about all that stuff going in, (and it's not even a money thing) i'd be perfectly happy making $150K as long as I got to do what I signed up for to do, but it seems like it's getting much worse and I don't want to train for 6+ years and be stuck reading only CXR or only doing abscess drains and PICCs, if anyone has any evidence to the contradictory. The current scene seems to be very similar to what happened in the 90's and then there was a rads shortage.

A lot of the negatives of ER (i.e. jerk surgeons/consultants/drug seekers) I found entertaing, and there are always the moments where you get the one patient that makes your day go way better. I honestly probably would have pursued ER more except I was worried about the hole "burnout when your 40 thing"

any light on either field from people who have been there would be appereciated

 

[DrQuinn]

it's not that I don't like rads, I think it's by far the most interesting/intellectual field in medicine, the appeal was/is, they get to see everything and it's very versatile (like ER), but it seems that other people are realizing that too i.e. ortho/cards/vasc surgery and have eaten up or are trying to take up the other good stuff, and I knew about all that stuff going in, (and it's not even a money thing) i'd be perfectly happy making $150K as long as I got to do what I signed up for to do, but it seems like it's getting much worse and I don't want to train for 6+ years and be stuck reading only CXR or only doing abscess drains and PICCs, if anyone has any evidence to the contradictory. The current scene seems to be very similar to what happened in the 90's and then there was a rads shortage.

A lot of the negatives of ER (i.e. jerk surgeons/consultants/drug seekers) I found entertaing, and there are always the moments where you get the one patient that makes your day go way better. I honestly probably would have pursued ER more except I was worried about the hole "burnout when your 40 thing"

any light on either field from people who have been there would be appereciated

Keep in mind that things vary in residnecy than they do out in the "real world" i.e. community medicine. EMers and radiologists out in the community are very different from those same specialties in academic settings. I can tell you that out in the community burnout is far less and people seem to just be... happier.

Oh, and I used to say "I would be happy making 150k a year knowing etc..." but once you see the $$ that rads and EM makes I am pretty sure you wouldn't take a 50%-75% paycut!
Q